Developing and evaluating the Teen-Strong life skills programme in Southern Thailand.

Risk sexual behaviours are known as a threat to health and wellbeing of adolescents. Although there are standard sexual education curriculums in Thai schools, most schools use traditional teaching methods rather than participatory teaching activities. This study aimed to (i) develop 'Teen-Strong' programme by combining the concept of the World Health Organization's life skills programme with Thai sexual education curriculum and (ii) investigate the association of Teen-Strong programme with knowledge and decision-making regarding risky sexual behaviours and teenage pregnancy in Thai adolescents. The Teen-Strong programme was developed by means of experts review and cognitive interviewing process and evaluated in 66 adolescents in Grades 7-9 from six schools in southern Thailand. Twenty-six students were assigned to the experimental group (attended Teen-Strong programme and standard sexual education) and 40 to the control group (attended only the standard sexual education). A pre-post-test quasi-experimental design was used and the Teen-Strong questionnaire (TSQ) was administered to measure knowledge and decision-making at three time points: before (T1), immediately after (T2) and 1 month after (T3) attending the programme. A 2 × 3 mixed-design ANOVA was used to analyse the data. TSQ scores in the experimental and control groups were higher at T2 and T3 as compared with T1. Mean increase in TSQ scores at T2 and T3 compared with T1 were significantly higher in the experiment than the control group [T2 vs. T1: t (64) = 4.07, p-values < 0.0001; T3 vs. T1: t (64) = 3.32, p-values = 0.017]. This study showed that Teen-Strong programme could increase adolescent's knowledge and decision-making skills regarding risk sexual behaviours.

Sexual practices during adolescence are shown to cause teenage pregnancy and other threats to the health and wellbeing of adolescents in Thailand. Adolescent sexual education that considers the culture and environment where adolescents grow up is essential. Although there are sexual education programmes in Thai schools, most schools use traditional teaching methods (i.e. learning through memorization) rather than participatory teaching activities (i.e. learning through activities and sharing experiences from and with peers). We developed a programme called 'Teen-Strong' by combining participatory learning technique proposed by the World Health Organization with the Thai sexual education programme and evaluate whether this hybrid programme helped Thai adolescents in Grades 7­9 to better understand and avoid risky sexual behaviours. We found that adolescents who were involved in the Teen-Strong programme showed better knowledge and decision-making skills at avoiding risky sexual practices than adolescents who were not involved in the programme. Our findings show participatory sexual education programme could enhance adolescents' understanding of risky sexual practices and strategies to avoid these risky practices.

Development and evaluation of a preparation model for the Indonesian nursing licensure examination: A participatory action research.

BACKGROUND: The long-standing underachievement in the Indonesian national nursing competency examination (NNCE) has been a common concern, and there is limited information on the preparation program for this licensure examination. OBJECTIVE: To develop an NNCE preparation program model and evaluate its effectiveness in increasing competency among nursing graduates. DESIGN: A quasi-experimental study using participatory action research (PAR). SETTING: Faculty of nursing of a full-boarding private university in Indonesia. PARTICIPANTS: The participants were selected with the purposive sampling method. The 23 course coordinators and clinical instructors met the inclusion criteria of having worked for at least five years as classroom teachers and at least one year as course coordinators or clinical instructors. The 85 nursing graduates met the inclusion criteria of having finished the internship program and planned to take the NNCE. METHODS: The model was developed using PAR and the evaluation done to measure the increase in the competency level and the level of perceived readiness and satisfaction of both the participant educators and nursing graduates. RESULTS: The proposed model consists of core components and essential concepts. The core components are a holistic preparation process, active involvement and participation, knowledge and skill specialty, sharp examination-taking and skills, motivation to join the program and self-confidence to pass the NNCE, and time commitment for the preparation program. The essential concepts consist of awareness and trust, desire to change, sense of responsibility, mutual collaboration, equipped and empowered to act, definite direction and goals, mentoring. The model's evaluation indicated a significant increase in competency level, overall perceived readiness for the national nursing competency examination, and degree of satisfaction with the preparation program. CONCLUSIONS: The implementation of the preparation model effectively increased the nursing graduates' competency level, and both the participating educators and nursing graduates were satisfied with its effectiveness.

Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand.

BACKGROUND: Increasing worldwide rates of cesarean section are of global concern. In recent years, cesarean births upon maternal request have become a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications. METHODS: A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women who preferred cesarean birth, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019. Data were analyzed using content analysis. RESULTS: Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates. Most women had more than one reason for opting cesarean birth. CONCLUSION: Several reasons for cesarean birth preference have been elucidated. One striking reason was superstitious beliefs in auspicious birth dates, which are challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth in order to prevent or diminish unnecessary cesarean births.